M Ali Khan1, Abtin Shahlaee1, Brian Toussaint2, Jason Hsu1, Arunan Sivalingam1, Pravin U Dugel3, Rohit R Lakhanpal4, Christopher D Riemann2, Maria H Berrocal5, Carl D Regillo1, Allen C Ho6. 1. Wills Eye Hospital, Philadelphia, Pennsylvania. 2. Cincinnati Eye Institute and University of Cincinnati, Cincinnati, Ohio. 3. Retina Consultants of Arizona, Phoenix, Arizona; University of Southern California (USC) Eye Institute, Keck School of Medicine, Los Angeles, California. 4. Eye Consultants of Maryland, Owings Mills, Maryland. 5. Berrocal & Associates, San Juan, Puerto Rico. 6. Wills Eye Hospital, Philadelphia, Pennsylvania. Electronic address: acho@midatlanticretina.com.
Abstract
PURPOSE: To report the initial experience, clinical outcomes, and safety profile of 27 gauge pars plana vitrectomy (PPV) in eyes with posterior segment disease. DESIGN: Multicenter, retrospective, interventional case series. METHODS: setting: Private practice and tertiary care settings. STUDY POPULATION: Eyes undergoing 27 gauge PPV for a vitreoretinal surgery indication. INTERVENTION: Three-port, transconjunctival 27 gauge PPV. MAIN OUTCOME MEASURES: Change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 90 days. RESULTS: Ninety-five eyes met the inclusion criteria. Surgical indications included epiretinal membrane (n = 26), diabetic tractional retinal detachment (n = 14), full-thickness macular hole (n = 11), rhegmatogenous retinal detachment with (n = 7) or without (n = 9) proliferative vitreoretinopathy (PVR), vitreous hemorrhage (n = 10), vitreous opacities (n = 8), endophthalmitis (n = 4), sub-silicone oil retinal detachment (n = 3), retained lens material (n = 1), submacular hemorrhage (n = 1), and aqueous misdirection (n = 1). Mean logMAR visual acuity improved from 1.08 ± 0.71 (20/240 Snellen equivalent) preoperatively to 0.53 ± 0.65 (20/67 Snellen equivalent) postoperatively (P < .001). Mean follow-up was 144 days (median 127 days, range 90-254 days). There were no intraoperative complications and no case required conversion to 20, 23, or 25 gauge instrumentation. A total of 3 sclerotomy sites (1.1%) were sutured at the conclusion of surgery. Postoperative complications included transient ocular hypertension in 8 eyes (8.4%), transient hypotony in 5 eyes (5.3%), and vitreous hemorrhage in 5 eyes (5.3%). No cases of postoperative endophthalmitis, sclerotomy-related retinal tears, or choroidal detachments were encountered in the follow-up period. CONCLUSION: The 27 gauge PPV was well tolerated with low rates of intraoperative and postoperative complications across varied surgical indications.
PURPOSE: To report the initial experience, clinical outcomes, and safety profile of 27 gauge pars plana vitrectomy (PPV) in eyes with posterior segment disease. DESIGN: Multicenter, retrospective, interventional case series. METHODS: setting: Private practice and tertiary care settings. STUDY POPULATION: Eyes undergoing 27 gauge PPV for a vitreoretinal surgery indication. INTERVENTION: Three-port, transconjunctival 27 gauge PPV. MAIN OUTCOME MEASURES: Change in visual acuity and occurrence of intraoperative and postoperative complications with minimum follow-up of 90 days. RESULTS: Ninety-five eyes met the inclusion criteria. Surgical indications included epiretinal membrane (n = 26), diabetic tractional retinal detachment (n = 14), full-thickness macular hole (n = 11), rhegmatogenous retinal detachment with (n = 7) or without (n = 9) proliferative vitreoretinopathy (PVR), vitreous hemorrhage (n = 10), vitreous opacities (n = 8), endophthalmitis (n = 4), sub-silicone oil retinal detachment (n = 3), retained lens material (n = 1), submacular hemorrhage (n = 1), and aqueous misdirection (n = 1). Mean logMAR visual acuity improved from 1.08 ± 0.71 (20/240 Snellen equivalent) preoperatively to 0.53 ± 0.65 (20/67 Snellen equivalent) postoperatively (P < .001). Mean follow-up was 144 days (median 127 days, range 90-254 days). There were no intraoperative complications and no case required conversion to 20, 23, or 25 gauge instrumentation. A total of 3 sclerotomy sites (1.1%) were sutured at the conclusion of surgery. Postoperative complications included transient ocular hypertension in 8 eyes (8.4%), transient hypotony in 5 eyes (5.3%), and vitreous hemorrhage in 5 eyes (5.3%). No cases of postoperative endophthalmitis, sclerotomy-related retinal tears, or choroidal detachments were encountered in the follow-up period. CONCLUSION: The 27 gauge PPV was well tolerated with low rates of intraoperative and postoperative complications across varied surgical indications.
Authors: Mikel Mikhail; Andre Ali-Ridha; Sarah Chorfi; Michael A Kapusta Journal: Graefes Arch Clin Exp Ophthalmol Date: 2017-07-15 Impact factor: 3.117
Authors: Mikel Mikhail; Andre Ali-Ridha; Sarah Chorfi; Michael A Kapusta Journal: Graefes Arch Clin Exp Ophthalmol Date: 2016-08-02 Impact factor: 3.117
Authors: Okan Toygar; Cindy W Mi; Daniel M Miller; Christopher D Riemann Journal: Graefes Arch Clin Exp Ophthalmol Date: 2016-04-19 Impact factor: 3.117